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The Lancet NCDI Poverty Commission: bridging a gap in universal health coverage for the poorest billion
For the poorest of our world, non-communicable diseases
and injuries (NCDIs) account for more than a third of their
burden of disease; this burden includes almost
800000 deaths annually among those aged younger than
40 years, more than HIV, tuberculosis, and maternal
deaths combined.
• Despite already living in abject poverty, between
19 million and 50 million of the poorest billion spend a
catastrophic amount of money each year in direct
out-of-pocket costs on health care as a result of NCDIs.
• Progressive implementation of affordable, cost-effective,
and equitable NCDI interventions between 2020 and 2030
could save the lives of more than 4·6 million of the world’s
poorest, including 1·3 million who would otherwise die
before the age of 40 years.
• To avoid needless death and suffering, and to reduce the
risk of catastrophic health spending, essential NCDI
services must be financed through pooled, public
resources, either from increased domestic funding or
external funds.
• National governments should set and adjust priorities
based on the best available local data on NCDIs and the
specific needs of the worst off.
• International development assistance for health should
be augmented and targeted to ensure that the poorest
families affected by NCDIs are included in progress
towards universal health care